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Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: International standards guideline statement
Author(s) -
Randolph Gregory W.,
Dralle Henning,
Abdullah Hisham,
Barczynski Marcin,
Bellantone Rocco,
Brauckhoff Michael,
Carnaille Bruno,
Cherenko Sergii,
Chiang FenYu,
Dionigi Gianlorenzo,
Finck Camille,
Hartl Dana,
Kamani Dipti,
Lorenz Kerstin,
Miccolli Paolo,
Mihai Radu,
Miyauchi Akira,
Orloff Lisa,
Perrier Nancy,
Poveda Manuel Duran,
Romanchishen Anatoly,
Serpell Jonathan,
SitgesSerra Antonio,
Sloan Tod,
Van Slycke Sam,
Snyder Samuel,
Takami Hiroshi,
Volpi Erivelto,
Woodson Gayle
Publication year - 2011
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21119
Subject(s) - guideline , medicine , recurrent laryngeal nerve , multidisciplinary approach , medical physics , intensive care medicine , thyroid , pathology , social science , sociology
Intraoperative neural monitoring (IONM) during thyroid and parathyroid surgery has gained widespread acceptance as an adjunct to the gold standard of visual nerve identification. Despite the increasing use of IONM, review of the literature and clinical experience confirms there is little uniformity in application of and results from nerve monitoring across different centers. We provide a review of the literature and cumulative experience of the multidisciplinary International Neural Monitoring Study Group with IONM spanning nearly 15 years. The study group focused its initial work on formulation of standards in IONM as it relates to important areas: 1) standards of equipment setup/endotracheal tube placement and 2) standards of loss of signal evaluation/intraoperative problem‐solving algorithm. The use of standardized methods and reporting will provide greater uniformity in application of IONM. In addition, this report clarifies the limitations of IONM and helps identify areas where additional research is necessary. This guideline is, at its forefront, quality driven; it is intended to improve the quality of neural monitoring, to translate the best available evidence into clinical practice to promote best practices. We hope this work will minimize inappropriate variations in monitoring rather than to dictate practice options. Laryngoscope, 121:S1–S16, 2011